Tracy Lyn Anonich, R.PH
Individual provider Active NPI Pharmacist · Mukwonago, WI
NPI 1700109873 · NPPES record last updated Mar 3, 2010
Key facts
- NPI
- 1700109873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 11539 (WI)
- Practice address
- 801 N Rochester St
Mukwonago, WI 53149-1142 - Phone
- (262) 363-4001
- NPI assigned
- Mar 3, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miller Pharmacy, Inc. | Pharmacist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11539 | WI | Yes |
Addresses
Primary practice location
801 N Rochester St
Mukwonago, WI 53149-1142
Mailing address
S93W33534 Fieldside CT
Mukwonago, WI 53149-8202
Phone (262) 594-3023
Other providers in Mukwonago, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.